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Review
. 2013 Oct;132(4):e817-24.
doi: 10.1542/peds.2013-1112. Epub 2013 Sep 23.

Trends in invasive methicillin-resistant Staphylococcus aureus infections

Martha Iwamoto  1 , Yi Mu, Ruth Lynfield, Sandra N Bulens, Joelle Nadle, Deborah Aragon, Susan Petit, Susan M Ray, Lee H Harrison, Ghinwa Dumyati, John M Townes, William Schaffner, Rachel J Gorwitz, Fernanda C Lessa
Affiliations
Review

Trends in invasive methicillin-resistant Staphylococcus aureus infections

Martha Iwamoto et al. Pediatrics. 2013 Oct.

Abstract

Objective: To describe trends in the incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in children during 2005-2010.

Methods: We evaluated reports of invasive MRSA infections in pediatric patients identified from population-based surveillance during 2005-2010. Cases were defined as isolation of MRSA from a normally sterile site and classified on the basis of the setting of the positive culture and presence or absence of health care exposures. Estimated annual changes in incidence were determined by using regression models. National age- and race-specific incidences for 2010 were estimated by using US census data.

Results: A total of 876 pediatric cases were reported; 340 (39%) were among infants. Overall, 35% of cases were hospital-onset, 23% were health care-associated community-onset, and 42% were community-associated (CA). The incidence of invasive CA-MRSA infection per 100000 children increased from 1.1 in 2005 to 1.7 in 2010 (modeled yearly increase: 10.2%; 95% confidence interval: 2.7%-18.2%). No significant trends were observed for health care-associated community-onset and hospital-onset cases. Nationally, estimated invasive MRSA incidence in 2010 was higher among infants aged <90 days compared with older infants and children (43.9 vs 2.0 per 100000) and among black children compared with other races (6.7 vs 1.6 per 100000).

Conclusions: Invasive MRSA infection in children disproportionately affects young infants and black children. In contrast to reports of declining incidence among adults, there were no significant reductions in health care-associated MRSA infections in children. Concurrently, the incidence of CA-MRSA infections has increased, underscoring the need for defining optimal strategies to prevent MRSA infections among children with and without health care exposures.

Keywords: Staphylococcus aureus infection; children; epidemiology; infants; methicillin resistance.

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Conflict of interest statement

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Incidence of late-onset, HO invasive MRSA infections in infants aged 3 to 89 days by race, 2005–2010. The analysis was restricted to surveillance counties that reported continuously during 2005–2010. †Controlled for gender and race.
FIGURE 2
FIGURE 2
Trends in age-, gender-, and race-adjusted incidence of invasive MRSA infections among children aged 3 months to 17 years, by epidemiologic category, 2005–2010. The analysis was restricted to surveillance counties that reported continuously during 2005–2010. †Controlled for age, gender, and race.
See this image and copyright information in PMC

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